Fear and rumours can be as dangerous as the virus itself. Community health workers are battling misconceptions among expectant mothers.
Fear and rumours can be as dangerous as the virus itself. Community health workers are battling misconceptions among expectant mothers.
During the early phase of the pandemic, a rumour spread among pregnant women in Dar es Salaam’s Magomeni suburb: ‘If you go to the hospital to give birth, you will get corona and you will die’.
Expectant mothers were caught between a rock and a hard place; either they would run the risk of coronavirus infection at the hospital or risk complications during home birth – which was the lesser evil?
For 26-year-old Aisha Hussein, the fear was overwhelming.
“I am afraid about how it will be to give birth at the hospital, growing more scared by every day,” she said in early June when I sat down with her outside her home, a humble one-room apartment, squeezed into a small compound with several other families.
However, in a time of fear and misinformation, she found comfort in the advice of the area’s community health workers. Community health worker Catherine Mselem helped her get through the anxiety of pregnancy – coupled with the uncertainty of the pandemic. She assured her that the hospital has measures in place to reduce the risk of infection and she informed her on how to reduce the risk at home, washing hands, wearing a mask, and avoiding crowds.
“Mama has helped me with information to keep me safe,” said Aisha Hussein who respectfully refer to Catherine Mselem as ‘mama’.
Motherly advice
In a sense, the 48-year-old community health worker is a mother figure for many pregnant women in the area. Her flowery dress and her calm but steadfast demeanour instantly make people around her relax, share their thoughts, and listen to her. The pregnant women in the area are often young, living alone or with their parents and struggling to sort through misinformation and rumours that swirl through the community.
“We are encouraging them to go to the hospital or clinic for ultrasound and we offer to escort them to the hospital for delivery,” says Catherine Mselem and adds, “so to remove their fear”.
Maternal mortality is one of the key issues of concern among scholars and medical professionals during the pandemic. According to estimates by global health experts published in The Lancet, the pandemic could cause more than 1,5 million additional child deaths and over 56,000 additional maternal deaths over six months in low- and middle-income countries if health systems are overwhelmed and access to food is limited.
And while Catherine Mselem was worried that maternal and new-born deaths could increase during the pandemic because of an increase in home births, this has luckily not been the case. She did not record any maternal or child deaths in her area from March to June. Along with her fellow community health worker, 45-year-old Japhet Mhando, she visited around 300 homes during that period, spreading information about COVID-19 prevention, advising families on family planning, detecting malaria, or referring patients with HIV or tuberculosis symptoms for testing.
Education is key
Although community health workers are not trained in attending births or permitted to administer medicine, they are a vital link between communities and medical facilities.
After the community health workers began to encourage pregnant women to visit a health facility for regular check-ups, they have witnessed a decline in the number of home births and the maternal and child mortality rate has gone down. And during the pandemic, their efforts in educating the community has been vital in slowing down the infection rate, argues Japhet Mhando:
“People have sanitizer in their pockets and handwashing stations in front of their shops. And that’s why corona is not so bad here,” he says,
“It is a question of education”.